NPI 1992714588 · live from the CMS NPI Registry
Charles W Bagley, PNP
Nurse Practitioner, Pediatrics in Collierville, TN. National Provider Identifier 1992714588, active.
NPI record
| NPI | 1992714588 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 120 Crescent Dr, Collierville, TN 38017 |
| Practice phone | 901-757-3560 |
| Mailing address | 8110 Walnut Run Rd, Cordova, TN 38018 |
| Enumerated | August 5, 2006 |
| Last updated | July 8, 2007 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | 121342 (TN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.